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An anatomical study of persistent trigeminal artery detected by computed tomography angiography and magnetic resonance angiography: proposal for a modified classification and a novel basilar artery grading system

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Abstract

Purpose

The purpose of this study is to investigate the anatomical characteristics of persistent trigeminal artery (PTA) detected by computed tomography angiography (CTA) and magnetic resonance angiography (MRA), propose a modified classification and a novel grading system for basilar artery (BA).

Methods

Patients who underwent head CTA or MRA in our hospital between August 2014 and August 2022 were reviewed retrospectively. The prevalence, sex, and course of PTA were evaluated. PTA types were modified based on Weon’s classification. Type I to IV were similar to those in Weon’s classification except the presence of intermed fetal-type posterior cerebral artery (IF-PCA). Type V was the same as that in Weon’s classification. Type VI included subtypes of VIa (concomitant IF-PCA based on type I to IV) and VIb (other variants). BA was assessed based on a scale of 0 to 5 compared with PTA’s caliber (0, BA aplasia; 1 and 2, BA non-dominant; 3, equilibrium; 4 and 5, BA dominant).

Results

A total of 57 patients (0.06%) with PTA, including 36 females and 21 males, were detected in 94,487 patients. Six patients (10.5%) were medial type and 51 patients (89.5%) were lateral type. Thirty-seven patients (64.9%) were type I, 1 (1.8%) as type II, 13 (22.8%) as type III, 3 (5.3%) as type IV, 1 (1.8%) as type V, and 2 (3.5%) as type VI. For BA grading, 4 (7.0%), 21 (36.8%), 17 (29.8%), 6 (10.5%), 6 (10.5%), and 3 (5.3%) of the patients were grade 0, 1, 2, 3, 4, and 5, respectively. Fifteen patients (26.3%) had intracranial aneurysms. One cases (1.8%) had a fenestration of the PTA.

Conclusion

The prevalence of PTA in our study was lower than that in most previous reports. The modified PTA classification and BA grading system can be used to better understand the vascular structure of PTA patients.

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Data availability

The data that support the findings of this study are available on request from the contact author, Wei Huang, upon reasonable request.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Medical Imaging, the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, Jiangsu, China

    Wei Huang, Yingying Zhuang, Yuzhen Shi & Yun Feng

  2. Department of Radiotherapy, the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, Jiangsu, China

    Yan Zhang

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  1. Wei Huang
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  4. Yuzhen Shi
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Contributions

WH and YF contributed to the study conception and design. YZ and YS contributed to material preparation and data collection. Data analysis was performed by WH and YYZ. The first draft of the manuscript was written by WH and YZ. The manuscript was edited by YF. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yun Feng.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethics committee of our local institution (Date: 12.22.2022. Number: KY-2022-144-01).

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Informed consent was obtained from all individual participants included in the study.

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Huang, W., Zhang, Y., Zhuang, Y. et al. An anatomical study of persistent trigeminal artery detected by computed tomography angiography and magnetic resonance angiography: proposal for a modified classification and a novel basilar artery grading system. Surg Radiol Anat 45, 947–957 (2023). https://doi.org/10.1007/s00276-023-03164-1

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